Hospital Resources

  • Health Care Exchanges

    On October 1, 2013, new health insurance options were made available to the American public as part of the Affordable Care Act (ACA).  These new insurance plans provide another option for obtaining health insurance coverage.  Currently, most individuals obtain insurance coverage by purchasing it themselves, via their employer, or are eligible for coverage provided by the government (eg, Medicare and/or Medicaid).  The information provided here only addresses the new health insurance options being made available via ACA (aka “exchanges” or “exchange plans”).  Additional information regarding the exchange plans is available through www.healthcare.gov

    This new online marketplace allows individuals to:

    • shop for health insurance options in their state
    • compare health plans
    • purchase and enroll in a health plan  

    The plans on the Health Insurance Marketplace are separated into 4 health plan categories — Bronze, Silver, Gold, or Platinum. Each metallic level varies by the percentage of costs you have to pay on average toward the health care you receive in the form of deductible, coinsurance, and/or co-payments.  Review plan details of coverage carefully before choosing.  

    State-by-State Health Plans - Updated

    Each state approved specific companies to sell plans on the exchanges. Many hospitals, including Cincinnati Children's, do not contract with all of the plans in their state's exchange. It is important that individuals confirm that their child’s preferred providers are in-network prior to selecting a new plan on the exchange. A good number of the insurance plans have limited or no out-of-network benefits and individuals will be financially responsible for all unpaid charges. To insure you and your family do not incur any unexpected out-of-pocket expenses for your child’s care at Cincinnati Children’s if you choose insurance through the new health care exchanges, Cincinnati Children’s recommends that you enroll in one of the plans listed in bold below with which Cincinnati Children’s is contracted as an in-network provider.

    *Note that this information is subject to change. Please re-check periodically for updates if your plan is listed as non-contracted.

    Ohio Exchange Plans

    Seven companies will operate plans in southwest Ohio. See a list of these plans below. Note the plans at the top of the list, in bold, are the plans that are considered in-network for Cincinnati Children's and its employed physicians. 

    • HUMANA Health Plan of Ohio
    • HealthSpan
    • MedMutual
    • NEW CareSource Just4Me– CCHMC is a contracted provider
    • Anthem Blue Cross Blue Shield – CCHMC is NOT a contracted provider
    • Ambetter from Buckeye Community Health Plan – CCHMC is NOT a contracted provider
    • Molina Marketplace – CCHMC is NOT a contracted provider

    Kentucky Exchange Plans

    Five companies are approved to sell plans on the exchange. See a list of these plans below. Note the plans at the top of the list, in bold, are the plans that are considered in-network for Cincinnati Children's and its employed physicians.

    • HUMANA Health Plan of Ohio
    • United HealthCare
    • NEW Kentucky Health Cooperative via the FIRST HEALTH NETWORK - CCHMC is a contracted provider
    • Anthem Blue Cross Blue Shield – CCHMC is NOT a contracted provider
    • BlueGrass Family Health – CCHMC is NOT a contracted provider

    Indiana Exchange Plans

    Four companies are approved to sell plans on the exchange, however, Anthem is the only carrier offering an exchange plan in southeast Indiana.  Cincinnati Children's and its employed physicians are not currently contracted with these companies.

    • Anthem Blue Cross Blue Shield – CCHMC is NOT a contracted provider
    • Managed Health Services – CCHMC is NOT a contracted provider
    • MDWise - CCHMC is NOT a contracted provider
    • PHP of Northern Indiana – CCHMC is NOT a contracted provider

    All Other States

    Please contact your local state exchanges for more information.  

 
  • Cincinnati Children's Contracts With Subset of Plans

    Note that Cincinnati Children’s Hospital does not contract with all of the plans in the exchange. It is important that you confirm that your preferred providers are in network prior to selecting a new plan on the exchange. Please note our contracted state-by-state plans on this page.
  • Health Insurance Online Marketplace

    Shop, compare and choose a plan at the website below.

    www.healthcare.gov